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Vermont rates for HCPCS J2250

Injection Midazolam Hydrochloride Per 1 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $3.84 / $8.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.17 / $0.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.17 / $0.17 / $0.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.24
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.15 / $0.23